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Inv# 2024-00000738 - Fidelity Security Life Insurance Company - 08/28/2024
FULL ROSTER ROSTER LISTING FOR:The City of Dania Beach BILLING PERIOD:August, 2024 INVOICE NUMBER:166381910 FULL MONTH LIST EM Subscriber ID Last Name First Name Billing Tier Plan Rate 26265734500 ACOSTA RAFAEL Employee + Family Benefit Level 1 $12.24 26265766300 ADAMS LORI Employee Only Benefit Level 1 $4.39 26265731400 ALI RICKY Employee + Family Benefit Level 1 $12.24 26265784900 ALPHONSE LOU Employee + 1 Benefit Level 1 $8.33 27619023300 AZCANO ALEJANDRO Employee Only Benefit Level 1 $4.39 32980066300 BALDELOMAR-BERNARDIN FARACH Employee Only Benefit Level 1 $4.39 26265787900 BALDIE TOMMY Employee + Family Benefit Level 1 $12.24 27805779400 BATISTA CLAUDIA Employee + Family Benefit Level 1 $12.24 26265734000 BOUTSIS EVE Employee Only Benefit Level 1 $4.39 30365342500 BRATHWAITE DAVID Employee Only Benefit Level 1 $4.39 26265754300 BROWN LOUIS Employee Only Benefit Level 1 $4.39 32980064300 BROWN MELISSA Employee Only Benefit Level 1 $4.39 26265783800 BROWN RODRICK Employee + 1 Benefit Level 1 $8.33 27498160300 BROWNE JOHNATHAN Employee + 1 Benefit Level 1 $8.33 30365341800 CADY JONATHAN Employee Only Benefit Level 1 $4.39 26265792000 CANGIALOSI JOSEPH Employee + 1 Benefit Level 1 $8.33 28272983000 CASERTA CHRISTINA Employee Only Benefit Level 1 $4.39 33154195200 CASTLEBERRY AISHA Employee + 1 Benefit Level 1 $8.33 32586257000 CHAPMAN PORTES JESSICA Employee + 1 Benefit Level 1 $8.33 30925469500 CHAVARRIA ALBERTO Employee Only Benefit Level 1 $4.39 26265749600 CHEN MICHAEL Employee + 1 Benefit Level 1 $8.33 26265786300 COLLINS ROGER Employee + 1 Benefit Level 1 $8.33 26265787600 COOK RONALD Employee + Family Benefit Level 1 $12.24 33088965100 CORNILEUS TYRONE Employee Only Benefit Level 1 $4.39 26265771800 COSTA NATHAN Employee + Family Benefit Level 1 $12.24 26265788400 CRAWFORD RUPERT Employee + Family Benefit Level 1 $12.24 26265743800 CROSS JERRYLYN Employee Only Benefit Level 1 $4.39 26265776000 DAMIS WINDY Employee + Family Benefit Level 1 $12.24 26265788900 DAVILA EDDA Employee + Family Benefit Level 1 $12.24 26265766900 DAVIS JOYCE Employee Only Benefit Level 1 $4.39 26265737000 DE JESUS GABRIEL Employee + 1 Benefit Level 1 $8.33 26265776900 DEMASSIS TAMARA Employee + Family Benefit Level 1 $12.24 26265777700 DIPAOLO FRANK Employee + Family Benefit Level 1 $12.24 32686310200 DIXON DEANDRALOE Employee Only Benefit Level 1 $4.39 29558851400 DOMINGUEZ MARIA Employee + 1 Benefit Level 1 $8.33 ROSTER REPORT 26265736100 DONNELLY COLIN Employee + Family Benefit Level 1 $12.24 26265763800 DOTSON RICKEY Employee Only Benefit Level 1 $4.39 28482490200 EDGE CHARLES Employee Only Benefit Level 1 $4.39 27498159900 EKLE ROBERT Employee Only Benefit Level 1 $4.39 26265789700 GARDNER KALA Employee + Family Benefit Level 1 $12.24 32889851100 GIL JOSE Employee Only Benefit Level 1 $4.39 30968474400 GORDON SHARINA Employee Only Benefit Level 1 $4.39 26265769700 GRANT MITCHELL Employee + 1 Benefit Level 1 $8.33 26265779500 GREENE DARREN Employee + Family Benefit Level 1 $12.24 26265794200 GUZMAN YEIMY Employee + Family Benefit Level 1 $12.24 27523150200 HIRSCH STACY Employee + 1 Benefit Level 1 $8.33 26265770900 HUCK MICHAEL Employee + Family Benefit Level 1 $12.24 26265788700 HUGHES ANASTACIA Employee + Family Benefit Level 1 $12.24 26265789100 ICENHOUR RACHEL Employee + Family Benefit Level 1 $12.24 26265742400 IFEDI ANTHONY Employee Only Benefit Level 1 $4.39 27644267300 IGLESIAS GUTIERREZ CLAUDIO Employee Only Benefit Level 1 $4.39 26265784600 JAMES TAMARA Employee + 1 Benefit Level 1 $8.33 26265759300 JAMES TAMMIE Employee + 1 Benefit Level 1 $8.33 26265775500 JELASO MEGAN Employee + Family Benefit Level 1 $12.24 26265791600 JOHNSON ANTOINE Employee Only Benefit Level 1 $4.39 26265774300 JOHNSON BRANDON Employee Only Benefit Level 1 $4.39 27371199000 JOHNSON JR KENNITH Employee + 1 Benefit Level 1 $8.33 26265791100 JOLLY CORY Employee + Family Benefit Level 1 $12.24 26265782700 JOSEPH PATRICK Employee Only Benefit Level 1 $4.39 26265737900 KALLICHARAN CARL Employee Only Benefit Level 1 $4.39 26265765000 LAJOIE CORINNE Employee + 1 Benefit Level 1 $8.33 26265793700 LARIOS IBARGUEN IBEL Employee Only Benefit Level 1 $4.39 28173565800 LAWSON RACHELLE Employee + Family Benefit Level 1 $12.24 32719653800 LAZO FRANKY Employee + Family Benefit Level 1 $12.24 29524268700 LEWELLEN LORI Employee + 1 Benefit Level 1 $8.33 27712664100 LIMA MARILANE Employee Only Benefit Level 1 $4.39 31520769100 LOPEZ JERRY Employee Only Benefit Level 1 $4.39 26265739100 LOTTIER CHRISTINE Employee + 1 Benefit Level 1 $8.33 33286678600 LUPOE TYLYSIA Employee Only Benefit Level 1 $4.39 33286678800 MACKEY JESSICA Employee + Family Benefit Level 1 $12.24 26265730200 MARTIN RALPH Employee + Family Benefit Level 1 $12.24 26265775100 MARTINEZ GABRIEL Employee Only Benefit Level 1 $4.39 28457335400 MCDONALD MARVIN Employee + Family Benefit Level 1 $12.24 27344168300 MCDOWELL KEITH Employee Only Benefit Level 1 $4.39 27551170900 MCFARLANE DARRYL Employee Only Benefit Level 1 $4.39 26265747300 MCHELLON DONIAL Employee + Family Benefit Level 1 $12.24 26265774800 MCLAREN KRISTEN Employee Only Benefit Level 1 $4.39 26265780800 MCNEAL GREGORY Employee + Family Benefit Level 1 $12.24 28482489600 MIEREZ ANN Employee Only Benefit Level 1 $4.39 26265785200 MIRANDA SHANESA Employee Only Benefit Level 1 $4.39 31520768400 MORALES ANGEL Employee Only Benefit Level 1 $4.39 33088965600 MORRIS JAMAL Employee Only Benefit Level 1 $4.39 26265783200 NORENA ELEANOR Employee + Family Benefit Level 1 $12.24 33233314300 NOTICE JADEEN Employee + Family Benefit Level 1 $12.24 26265786100 OZAYDIN DINCER Employee Only Benefit Level 1 $4.39 32913399000 PAUL ASHLEY Employee Only Benefit Level 1 $4.39 26265774500 PECORARO SHERRY Employee + Family Benefit Level 1 $12.24 26265776400 PEIRCE LOGAN Employee Only Benefit Level 1 $4.39 29908349000 PENATE ROQUE DELMIS Employee + Family Benefit Level 1 $12.24 26265774100 PEREZ FRANK Employee + 1 Benefit Level 1 $8.33 26265769600 PETERSON TERRY Employee + 1 Benefit Level 1 $8.33 32561548800 PETRISOR VALENTIN Employee + Family Benefit Level 1 $12.24 26265770000 POLLARD ALBERLEAN Employee + Family Benefit Level 1 $12.24 27475095000 QUINTERO JOHN Employee Only Benefit Level 1 $4.39 26265791900 REYES EDDIE Employee + 1 Benefit Level 1 $8.33 29673982300 RIERA ELORA Employee Only Benefit Level 1 $4.39 26265737300 RODRIGUEZ FERNANDO Employee Only Benefit Level 1 $4.39 26265778500 RODRIGUEZ HAROLD Employee + Family Benefit Level 1 $12.24 26265750100 RODRIGUEZ MICHAEL Employee + Family Benefit Level 1 $12.24 26265773800 RODRIGUEZ RICHARD Employee + Family Benefit Level 1 $12.24 30968476800 RODRIGUEZ SUSSETTE Employee Only Benefit Level 1 $4.39 29018095900 RYAN ARCHIBALD Employee + Family Benefit Level 1 $12.24 26265756100 SABINO DEBORAH Employee + 1 Benefit Level 1 $8.33 26265782500 SALGADO JOSE Employee + Family Benefit Level 1 $12.24 26265755700 SALVINO MARCO Employee Only Benefit Level 1 $4.39 27431566000 SANCHEZ CLAUDIA Employee + 1 Benefit Level 1 $8.33 26265792200 SANTANA TORRES JULIO Employee Only Benefit Level 1 $4.39 26265789400 SAUNDERS JANICE Employee + 1 Benefit Level 1 $8.33 31520767600 SCHUTTEN SEAN Employee Only Benefit Level 1 $4.39 26265780600 SEGAL ADAM Employee + Family Benefit Level 1 $12.24 28482489700 SHAHRYAR MICHELLE Employee + 1 Benefit Level 1 $8.33 26265747900 SHELEY CHERIE Employee Only Benefit Level 1 $4.39 26505006400 SINGH MAXINE Employee Only Benefit Level 1 $4.39 33127192700 SMITH ROY Employee Only Benefit Level 1 $4.39 33233315100 SOLOMON GARCIA Employee Only Benefit Level 1 $4.39 28173567800 SPEAR MITZIE Employee Only Benefit Level 1 $4.39 26265743300 SPENCER WILLIE Employee + 1 Benefit Level 1 $8.33 26265733300 STEINER MURRAY Employee Only Benefit Level 1 $4.39 26265781200 STEVENS TANIA Employee + 1 Benefit Level 1 $8.33 26265790400 TAYLOR CORRY Employee Only Benefit Level 1 $4.39 26265781900 TERRAZAS MONICA Employee + Family Benefit Level 1 $12.24 26265748900 THOMAS AHMAD Employee + Family Benefit Level 1 $12.24 30875560700 THOMAS ROMARIO Employee Only Benefit Level 1 $4.39 30875567900 THOMPSON GEORGE Employee + 1 Benefit Level 1 $8.33 26265733000 UROW BARBARA Employee + 1 Benefit Level 1 $8.33 26265737500 VASTA MICHAEL Employee Only Benefit Level 1 $4.39 30041810200 VLASIC ASHLEY Employee + 1 Benefit Level 1 $8.33 26265779300 WALTON ERIC Employee + Family Benefit Level 1 $12.24 26265769400 WAREN CASSANDRA Employee Only Benefit Level 1 $4.39 26265785400 WASHINGTON JR WILLIS Employee + Family Benefit Level 1 $12.24 26265760300 WEST COKENYA Employee + Family Benefit Level 1 $12.24 26265781600 WESTBERRY ANSON Employee + Family Benefit Level 1 $12.24 26265746500 WHITE DEON Employee Only Benefit Level 1 $4.39 31271062500 WHITSON ADAM Employee + 1 Benefit Level 1 $8.33 29428735500 WILLIAMS BRYSHAWN Employee Only Benefit Level 1 $4.39 26265778800 WILLIAMS DARIUS Employee + Family Benefit Level 1 $12.24 26265775300 WRITER CYRUS Employee Only Benefit Level 1 $4.39 26265785800 ZAPATA MARLON Employee + 1 Benefit Level 1 $8.33 Location Total:$1,093.00 26265741800 ADAMS LAURA Employee Only Benefit Level 1 $4.39 26265753100 ANSBRO THOMAS Employee + 1 Benefit Level 1 $8.33 26265756800 BAKER ERIC Employee Only Benefit Level 1 $4.39 26265758800 BAKER JAMES Employee Only Benefit Level 1 $4.39 26265744800 BERNARDO MICHAEL Employee + 1 Benefit Level 1 $8.33 27551170300 BERTINO BARBARA Employee Only Benefit Level 1 $4.39 26265772700 BERTUCCIO JOSEPH Employee + 1 Benefit Level 1 $8.33 26265752100 BLOCKER CHRISTY Employee Only Benefit Level 1 $4.39 26265750000 BLUST JAMES Employee + 1 Benefit Level 1 $8.33 26265744200 BOLTON CHESTER Employee Only Benefit Level 1 $4.39 26265761200 BRANDES GLORIA Employee + 1 Benefit Level 1 $8.33 26265740100 BRAVE JOANN Employee Only Benefit Level 1 $4.39 26265791500 BROWN KENNETH Employee Only Benefit Level 1 $4.39 26265755200 BROWN MICHAEL Employee + 1 Benefit Level 1 $8.33 31028365400 BRUNNEMER MIKAL Employee + 1 Benefit Level 1 $8.33 26265735800 CARUSO BRUCE Employee + 1 Benefit Level 1 $8.33 26265786600 CHANDLER CHRISTOPHER Employee + Family Benefit Level 1 $12.24 26265792500 CHERIAN DANIEL Employee + 1 Benefit Level 1 $8.33 30925039400 CONNOLLY ROBERT Employee Only Benefit Level 1 $4.39 26265754100 CRANDON FRANK Employee Only Benefit Level 1 $4.39 27304666100 DARA MICHAEL Employee Only Benefit Level 1 $4.39 26265751400 DENNY NANCI Employee Only Benefit Level 1 $4.39 26265759600 GARCIA GONZALO Employee + Family Benefit Level 1 $12.24 26265764100 GARDNER EULA Employee Only Benefit Level 1 $4.39 26265732300 GENNARO JOSEPH Employee + 1 Benefit Level 1 $8.33 26265732500 GIAQUINTO RALPH Employee + 1 Benefit Level 1 $8.33 26265770400 GILMOND RUSSELL Employee Only Benefit Level 1 $4.39 26265760000 GRAMMER THOMAS Employee Only Benefit Level 1 $4.39 26265766500 GREEN JACK Employee Only Benefit Level 1 $4.39 26265733600 HANSEN DONALD Employee + 1 Benefit Level 1 $8.33 26265769300 HESS ROBERT Employee + 1 Benefit Level 1 $8.33 26265747100 HOLDEN LLOYD Employee + 1 Benefit Level 1 $8.33 26265747600 HUMPHREY JAMES Employee + 1 Benefit Level 1 $8.33 26265752700 HUSOSKY JOSEPH Employee + Family Benefit Level 1 $12.24 26265759000 JOHNSON ANTHONY Employee Only Benefit Level 1 $4.39 26265742000 JOHNSON CHARLENE Employee + 1 Benefit Level 1 $8.33 26265787100 JOHNSON STANLEY Employee Only Benefit Level 1 $4.39 26265738400 JONES KRISTEN Employee Only Benefit Level 1 $4.39 26265751000 KENON FLOYD Employee Only Benefit Level 1 $4.39 26265747000 KIMMICH ROBERT Employee + 1 Benefit Level 1 $8.33 26265762000 KIRBY DONNA Employee + 1 Benefit Level 1 $8.33 26265738300 KOCH KENNETH Employee Only Benefit Level 1 $4.39 26265752400 LAND KENNETH Employee + 1 Benefit Level 1 $8.33 29345575300 LAVINA ARMENIO Employee Only Benefit Level 1 $4.39 26265752800 LEXA JOHN Employee + Family Benefit Level 1 $12.24 26265744500 LIEM BRUCE Employee Only Benefit Level 1 $4.39 26265736600 LORBER RICHARD Employee Only Benefit Level 1 $4.39 26265754500 MACE EUGENE Employee + Family Benefit Level 1 $12.24 26265767100 MARIANI MARK Employee + Family Benefit Level 1 $12.24 26265766100 MASON LINDA Employee Only Benefit Level 1 $4.39 26265748300 MCDONALD MARY Employee Only Benefit Level 1 $4.39 26265751900 MIKES ROBERT Employee Only Benefit Level 1 $4.39 26265751700 MILLER MILES Employee Only Benefit Level 1 $4.39 26265753400 MOLINA DEBBIE Employee Only Benefit Level 1 $4.39 26265773300 MORRIS GLENN Employee + 1 Benefit Level 1 $8.33 26265753600 MULFORD JAMES Employee Only Benefit Level 1 $4.39 26265773500 MUSTELIER JR ENRIQUE Employee + 1 Benefit Level 1 $8.33 28868349200 NEAL TODD Employee Only Benefit Level 1 $4.39 26265794800 ORLANDO DOMINIC Employee + 1 Benefit Level 1 $8.33 30968475500 PARRA ROBERT Employee + 1 Benefit Level 1 $8.33 26265768900 PATELLARO LOU ANN Employee Only Benefit Level 1 $4.39 26265758100 PATTERSON DIANNA Employee Only Benefit Level 1 $4.39 26265740600 PELLECER SERGIO Employee Only Benefit Level 1 $4.39 26265772200 PERRY LEONARD Employee Only Benefit Level 1 $4.39 32863597600 PETRUZZELLI JAMES Employee Only Benefit Level 1 $4.39 27831637800 PHIPPS BRIAN Employee Only Benefit Level 1 $4.39 26265749500 PINK NELSON Employee + 1 Benefit Level 1 $8.33 30850756900 QUIGLEY TIMOTHY Employee Only Benefit Level 1 $4.39 26265735300 RIGO RUDOLF Employee Only Benefit Level 1 $4.39 26265763100 RIVIERE JOSEPH Employee + 1 Benefit Level 1 $8.33 26265745600 ROBERSON CHARLENE Employee + 1 Benefit Level 1 $8.33 26265745100 RODRIGUEZ JOSE Employee Only Benefit Level 1 $4.39 26265757000 ROSE PERRY Employee + 1 Benefit Level 1 $8.33 26265765700 ROSS FRANK Employee + 1 Benefit Level 1 $8.33 27917802900 RUDBECK BENJAMIN Employee + Family Benefit Level 1 $12.24 26265761500 RUETH RICHARD Employee + 1 Benefit Level 1 $8.33 26265767400 SATTERFIELD NICKI Employee + 1 Benefit Level 1 $8.33 26265745200 SAVAGE JAMES Employee + 1 Benefit Level 1 $8.33 26265771300 SCHNEIDER THOMAS Employee + 1 Benefit Level 1 $8.33 27786125000 SIEB RICHARD Employee Only Benefit Level 1 $4.39 26265746000 SLADE CURTIS Employee Only Benefit Level 1 $4.39 26265753500 SMITH MICHAEL Employee Only Benefit Level 1 $4.39 26265762500 SNELL ARNOLD Employee + Family Benefit Level 1 $12.24 26265792800 SOMERS HOWARD Employee + 1 Benefit Level 1 $8.33 26265753700 STUBBS DANIEL Employee + 1 Benefit Level 1 $8.33 26265795200 SULLIVAN DARIN Employee Only Benefit Level 1 $4.39 26265742900 TARMEY EDWARD Employee + 1 Benefit Level 1 $8.33 26265750700 TUBRIDY THOMAS Employee + 1 Benefit Level 1 $8.33 26340925000 URTECHO JOSE Employee Only Benefit Level 1 $4.39 26265776600 WALTERS LEROY Employee + 1 Benefit Level 1 $8.33 26265788200 WARWICK PANSY Employee Only Benefit Level 1 $4.39 26265746700 WENTWORTH JEAN Employee Only Benefit Level 1 $4.39 26265771500 WHITAKER STEPHEN Employee Only Benefit Level 1 $4.39 26265768600 WILLIAMS LEO Employee + 1 Benefit Level 1 $8.33 26265750300 ZIDAR MATTHEW Employee + 1 Benefit Level 1 $8.33 Location Retiree Total:$633.51 Full Month Total:$1,726.51 8/2724 FULL ROSTER ROSTER LISTING FOR:The City of Dania Beach BILLING PERIOD:August, 2024 INVOICE NUMBER:166381910 RETRO ADJUSTMENTS LIST EM Subscriber ID Last Name First Name Plan Start Period Date End Period Date Retro Period Rate 26265781600 WESTBERRY ANSON Benefit Level 1 07/01/2024 07/31/2024 07/2024 ($8.33) 26265781600 WESTBERRY ANSON Benefit Level 1 07/01/2024 07/31/2024 07/2024 $12.24 Total Retro Adjustments for 07/2024 $3.91 Total Retro Adjustments for the Month of August, 2024 $3.91 ROSTER REPORT 8/27/24